Physicians use endoscopes during minimally invasive procedures to visualize the patient anatomy, diagnose various conditions, and deliver instrumentation to the treatment site. Devices are typically delivered via a working channel of the endoscope, which generally ranges from about 2.0 to 3.5 mm in diameter, and may be used to introduce catheters and other elongate devices, including forceps, scissors, brushes, snares, and baskets. Larger working channels of 5.0 mm in diameter are available in certain specialized endoscopes, and may be used to pass relatively large devices or provide capability for improved aspiration or decompression. Some devices, however, are simply too large to pass through available endoscopes. Moreover, the specialized endoscopes with larger working channels can be expensive, as well as difficult to intubate due to increased rigidity and outer diameter.
Devices too large for the endoscope working channel must be introduced through an alternate, and often more invasive procedure, such as laparoscopy or open surgery. Laparoscopic surgery involves creating 0.5-1.5 cm incisions in a patient's abdominal wall so that a laparoscope and other instruments can be introduced into the abdominal and pelvic cavities. Open surgery generally involves creating one or more long incisions in a patient, followed by extensive muscle stripping, prolonged retraction of tissues, denervation and devascularization of tissue. While effective at introducing larger devices, laparoscopic and open surgical procedures can increase the risk of complications and trauma to the patient, as well as extend recovery time and hospital stays.
What is needed are devices and methods for endoscopic introduction of medical devices too large for the endoscope working channel without necessitating the use of invasive procedures. Specifically, devices and methods are needed for introduction of medical devices alongside and external to an endoscope.